Keith, Katinka A
Keith, Katinka A is an individual health care provider with primary practice located at 2055 Kimball Ave Suite 100, Waterloo IA 50702-5014. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Keith, Katinka A can be contacted via phone (319) 272-2112.Contact Information
Primary practice address
2055 Kimball Ave Suite 100
Waterloo IA 50702-5014
Phone: (319) 272-2112
Fax: (319) 272-2107
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 00745 | Iowa |
Profile Details
| NPI number | 1790776433 |
|---|---|
| LBN Legal business name | Keith, Katinka A |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790776433 | NPPES |
| Iowa | MEDICAID | 1144634 |
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